CIRCADIAN INTERVENTIONS FOR THE RECENTLY RECENTLY BEREAVED ELDERLY

该项目的目的是测试旨在帮助寡妇和鳏夫过上健康、运转良好的生活的干预措施。具体而言，它旨在保护最近失去亲人的老年人免受睡眠中断以及由此造成的健康，情绪，警觉性和白天功能的损害。该干预被设计为在受试者的日常生活中发展高水平的规律性，从而增强她/他的昼夜节律的幅度和相位稳定性，以及鼓励健康的睡眠习惯。将与年龄进行比较， 性别匹配的对照组，将接受预防集中治疗（EFT），作为心理治疗安慰剂。将在配偶丧亲后3个月内招募60例目前未使用抗抑郁药的老年（65岁以上）受试者（两种性别）。一半将被随机分配到社会节奏疗法（SRT）干预（其中还包括健康睡眠实践的教育），另一半将被分配到EFT控制条件。SRT组将参加10次社交节律治疗课程（分布在6个月内）。治疗师会在此时 讨论受试者每天记录的每周日记，鼓励在日常活动中保持高度的规律性，如就寝时间、用餐、社交等，以及健康睡眠行为和理论的教育。 控制组将参加10次EFT会议。将有4个评价点：T1（基线）、T2（3个月）和T3（3个月）。T3（治疗完成时（6个月），T4（治疗后12个月随访）。将在T1和T3时对睡眠、昼夜节律、情绪、警觉性和表现进行36小时实验室评价。这将 包括36小时连续核心体温测量，2个晚上的多导睡眠图（PSG），警觉性的MPEG4评估，以及一组情绪，警觉性和表现测量。在每次实验室评价之前，以及在T2和T4时，将进行为期两周的现场评价，包括完成社会节律指标（SRM），以及完成为期两周的匹兹堡睡眠日记（PghSD），为期一周的体动记录，性能电池以及心理和身体健康、情绪、警觉性和幸福感的测量。主要 有待检验的假设是，老年寡妇的健康、功能、警觉性和表现水平是由其睡眠的质量和持续时间调节的，通过包括增加生活方式的规律性和健康睡眠习惯教育的治疗可以取得改善。还将使用其他组成项目数据进行全方案分析，以评估日常生活方式规律性（SRM评分）作为相当大的老年人群体中睡眠，健康和福祉之间联系的中介变量。

The aim of this Project is to test an intervention designed to help widows and widowers lead healthy well-functioning lives. Specifically, it seeks to protect recently bereaved elders from sleep disruptions and from resulting impairments in health, mood, alertness and daytime functioning. The intervention is designed to develop high levels of regularity in the subject's routine, and thus to enhance the amplitude and phase stability of her/his circadian rhythms, as well as encouraging healthy sleep practices. Comparisons will be made with an age and gender matched control group who will receive Emotion-Focused Therapy (EFT), which acts as a psychotherapy placebo. Sixty elderly (65y+) subjects (both genders), not currently using anti-depressants, will be recruited within 3 months of spousal bereavement. Half will be randomly assigned to the Social Rhythm Therapy (SRT) intervention (which will also include education in healthy sleep practices), and half to the EFT control condition. The SRT group will attend ten social rhythm therapy sessions (spread over 6 mos.) at which a therapist will discuss a weekly diary kept by the subject every day, encouraging a high level of regularity in daily events such as bedtimes, meals, social contacts, etc., as well as educating the subject in healthy sleep behaviors and theory. The control group will attend ten EFT sessions. There will be 4 evaluation points: T1 (baseline), T2 (3 mos. into treatment), T3 (at completion of treatment (6 mos.), T4 (12 month post-treatment follow-up). There will be a 36h laboratory evaluation of sleep, circadian rhythms, mood, alertness and performance at T1 and T3. This will involve 36h of continuous core body temperature measurement, 2 nights of polysomnography (PSG), an MSLT assessment of alertness, and a battery of mood, alertness and performance measures. Prior to each laboratory evaluation, and at T2 and T4, there will be a two-week field evaluation involving completion of the Social Rhythm Metric (SRM), as well as completion of a two-week Pittsburgh Sleep Diary (PghSD), one week of actigraphy, a performance battery and measures of mental and physical health, mood, alertness and well-being. The main hypothesis to be tested is that health, functioning, alertness well-being and performance levels in elderly widow(er)s are mediated by the quality and duration of their sleep, and that improvements can be wrought by a therapy involving increased lifestyle regularity and healthy sleep practices education. Program-wide analyses using other component project data will also be undertaken in order to evaluate daily lifestyle regularity (SRM score) as a mediating vadable in the link between sleep, health and well-being, in a fairly large group of seniors.